Organization
SOUTH BAY MENTAL HEALTH CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER SCANLON PHD (EXECUTIVE DIRECTOR)
(508) 559-0473
Entity
Organization
Contact information
Practice address
37 BELMONT ST, BROCKTON, MA 02301-5299
(508) 580-4691
Mailing address
37 BELMONT ST, BROCKTON, MA 02301-5299
(508) 580-4691
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
4222
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP0064
NURSE SPECIALIST
MA
Enumeration date
10/25/2006
Last updated
08/22/2020
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